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5day old+thrush+jaundice=:(

Wow... Glad this is my third baby or else I could see why women give up! 2 days ago I began having very sore nipples. Scabs, shooting pain, bright red areolas. I checked my latch with 2 nurses(plus my LLL book). Latch good, milk coming in. Jaundice escalating... LC thinks thrush. Now on nystatin and grapefruit seed extract. Baby wets at each feed and had 2 poops today so far. Any thoughts on getting over these hurdles sooner?? I am persistent through the pain! This too shall pass, right??

Re: 5day old+thrush+jaundice=:(

Jaundice: If milk is coming in and poops are increasing, the jaundice *should* start to rectify if it is typical jaundice. Nurse as much as you can, and you could consider hand expressing and/or pumping and giving baby your expressed milk as a supplement, maybe via cup or syringe to avoid bottle issues. More milk in = more poops = less jaundice is my thinking there.

Thrush. Ugh ugh ugh. OK, if it really is thrush, and lots of things are diagnosed as thrush but are not, but if it is, then unfortunately Nystatin is not the most effective prescription treatment, although of course is helps some moms. According to studies, fluconazole if much more effective. Baby and mom must be treated even if baby is assymptomatic. ALSO, the doses and treatment protocols reccomended by lactation profesionals for these prescription meds are almost never what a mom is prescribed by her doctor. It's never enough. Call your LC and have her read to you about thrush treatments and dosing from Breastfeeding Answers Made Simple (Mohrbacher, 2010)

Gentian Violet is another OTC treatment that many moms have found effective. Again, get the proper protocol it must be diluted.

Many moms find APNO (All Purpose Nipple Ointment) helpful. It is a prescription compound that you use topically. You could use it as well as your oral anti-fungals.

Things that are often thought to be thrush but are not: 1) Latch pain due to shallow latch. It does not matter how it looks, if latch is painful it may be an off latch. Is your nipple mishapen at all after nursing, like a lipstick, or creased?
2) Bacterial infection of the nipple-you can get a culture for this and it would be treated with oral anti-biotics
3) Vasospasm: is nipple white/blanching after nursing?

Re: 5day old+thrush+jaundice=:(

Thank you so much!! Now I am really wondering of it is thrush! I am being diligent about my latch, although it is tricky on one side(the painful side). My nipple has a small scab now and I get searing pain with each suck. He nurses for about 10-20 minutes with lots of big gulps, and I do feel relief afterwards. I am hoping to talk to my midwife today about switching to APNO. If it is thrush, will that also treat the baby? Your help is so encouraging!! Thanks!

Re: 5day old+thrush+jaundice=:(

Sometimes thrush does respond to a topical antifungal ointment (and there is one in APNO) so that may help. I don;t think it would treat baby as well, but if you are not sure it is even thush it may be best to try the APNO, keep working on latch and positioning and see what happens. In fact I guess it is typical to start treatment of thrush with a topical antifungal and only go to the oral antifungals if the topical does not work. So maybe it would be enough even if it would not really treat baby.

Have you worked with your midwife or a lactation consultant or anyone on the latch? It can help to have a trained pair of eyes when latch is tricky. But they have to take the time to watch you nurse for a bit, and if it hurts you need to tell them. I have seen what looks like a picture perfect latch cause nipple damage and also seen what looked like an awful, shallow, nipple nursing baby and mom is happy as can be, no pain, and baby getting plenty of milk. So its really important to pay attention to how it feels. Also, have you tried different positioning? What about laid back? for more see: http://www.llli.org/docs/00000000000...astfeeding.pdf and http://www.biologicalnurturing.com/

Re: 5day old+thrush+jaundice=:(

I spoke to my LC yesterday and will see her today. Since paying closer attention to my latch, my nipples are looking a lot better! Scabs are healing and redness is going. Still having pain in left side, pretty persistently. Hoping to figure it out today! Thank you for your help!!

Re: 5day old+thrush+jaundice=:(

so happy to report that it was just a latch problem! i wasn't "smooshing" the breast tissue enough for him to get it into his mouth. it was a shallow latch! (you were right!!) so, i got a sample of APNO, and i already see a difference. my nipples are healing! i am stacking motrin and tylenol for 36 hours and then dropping the tylenol for another 24 to see how the pain is. i can already feel a huge difference in the latch, though. sometimes i have to pop him off to re-latch, but it is worth it! also, at his check up today, he is back to his birth weight (actually an ounce more!) and we are free from bilirubin checks! we are now free to stay home! no more appointments!